A patient is discharged from the hospital and will need to change his left leg dressing using sterile technique two times per day. To prevent the development of further infection, the patient will need to

Wash hands for 30 seconds, remove the old dressing, rewash hands for 30 seconds, and apply a new dressing using forceps

C)

Cleanse hands with antibacterial waterless soap, apply sterile gloves and remove the old dressing, and apply the new dressing

D)

Wash hands for 1 minute, apply sterile gloves to remove the dressing, apply a new dressing, following cleansing with soap and water

Ans:

A

Feedback:

Decreasing the number of microorganisms present on body surfaces can help prevent and fight infection.

2.

The laboratory calls the nurse to report the patient has a shift of the differential count to the left. The nurse knows this indicates the patient most likely suffers from

A)

Viral infection

B)

Bacterial infection

C)

Chickenpox

D)

Hepatitis

Ans:

B

Feedback:

If the infection is severe or prolonged, the body cannot manufacture neutrophils quickly enough, resulting in the release of immature granulocytes into the blood. This increase in the number of immature cells is called a shift to the left or leftward shift in the granulocyte differential count.

3.

The nurse of a local university is examining a student who has swollen glands and small painful lesions of the mouth. The nurse expects to palpate swelling in the neck area because

A)

Lymphedema has been caused by lymphatic obstruction

B)

Lymphocytes and macrophages invade the lymph nodes

C)

There will be tumor formation in the lymph nodes

D)

The tonsils are the likely source of infection

Ans:

B

Feedback:

The swelling indicates that lymphocytes and macrophages in the lymph nodes are fighting the infection and trying to limit its spread.

4.

When an 86-year-old patient complains of inability to concentrate, uneasiness, lightheadedness, weakness, muscle and joint discomfort, and demonstrates normal temperature, the clinic nurse recalls that

A)

Without an elevated temperature, infection is not present

B)

The patients symptoms are typical of an elderly patient

C)

The elderly can have an infection without a fever

D)

An infection was present and has dissipated

Ans:

C

Feedback:

Older people may not show a fever or may produce only a low-grade fever when an infection is present.

5.

A patient is experiencing generalized weakness and body aches. In the progress of infection, the patient is in the

A)

Incubation period

B)

Prodromal period

C)

Acute period

D)

Convalescent period

Ans:

B

Feedback:

The prodromal period is characterized by nonspecific symptoms such as nausea, fever, general weakness, or aches and pains.

6.

Most nosocomial infections involve which of the following systems?

A)

Intravascular line

B)

Gastrointestinal

C)

Central nervous system

D)

Peripheral lines

Ans:

A

Feedback:

Most nosocomial infections involve the urinary tract, surgical or traumatic wounds, the respiratory tract, or bacteremia, in association with intravascular lines.

7.

A 70-year-old patient with chronic obstructive pulmonary disease has a respiratory infection being treated with antibiotics. He is also taking oral corticosteroids to assist in decreasing the inflammation in the lungs. The patient is prone to

A)

Superinfection

B)

Respiratory distress

C)

Nausea and vomiting

D)

Purpura

Ans:

A

Feedback:

Drug therapy can cause defects in the hosts response to infection. Steroids, chemotherapy, antimetabolites, and inappropriate or prolonged use of antibiotics can increase the risk of infection.

8.

An elderly hospitalized man develops severe diarrhea from gram-negative rods that compromised the normal flora of the bowel. What is the cause of the infection?

A)

Helminth

B)

Protozoa

C)

Nosocomial

D)

Virus

Ans:

C

Feedback:

Gram-negative rods, which comprise much of the bowels normal flora, are associated with nosocomial infections caused by self-contamination.

9.

Viruses invade living cells. Which of the following diseases is caused by a virus?

Urinary tract infections and respiratory infections are most common and most lethal for elderly patients.

12.

In adulthood, what factor makes individuals, particularly the elderly, susceptible to infections?

A)

Poor nutrition

B)

Increased exercise

C)

Communal living

D)

Decreasing thymus

Ans:

D

Feedback:

The thymus begins to shrink in late adolescence and continues to diminish into middle age, leading to a decline in cell-mediated and humoral immunity.

13.

The most common infections in children are

A)

Respiratory

B)

Gastrointestinal

C)

Neurologic

D)

Urinary

Ans:

A

Feedback:

The most common infections in early childhood are respiratory infections.

14.

Otitis media occurs in children because the

A)

Eustachian tube is long and twisted

B)

Eustachian tube has a downward turn

C)

Eustachian tube is shorter and straighter

D)

Eustachian tube is widened

Ans:

C

Feedback:

The most common infections in early childhood are respiratory infections. In children, the eustachian tubes are shorter and straighter; middle ear infections (otitis media) are common because bacteria can easily pass from the nasopharynx to the ear canal.

15.

Which of the following statements about neonatal development is accurate?

A)

Neonates may have an infection without fever

B)

Breast-fed infants do not become ill due to immunity

C)

Neonates prefer sleeping and often refuse to eat

D)

Neonates have defense to communicable disease

Ans:

A

Feedback:

Newborns have immature thermoregulatory mechanisms and do not become febrile.

16.

A nurse instructs a new mother on immunizations. An immunization produces

A)

Active immunity

B)

Humoral immunity

C)

Passive immunity

D)

Antigen immunity

Ans:

A

Feedback:

Active immunity can be produced by vaccination. Vaccination is the process of injecting weakened or killed organisms into a person, stimulating antibody production.

17.

Which of the following is considered the building block of the immune system?

A)

Red blood cells

B)

Macrocytes

C)

Macrophages

D)

T lymphocytes

Ans:

D

Feedback:

T and B lymphocytes are the building blocks of the immune system, accumulate in lymph nodes along lymphatic vessels, and are exposed to all antigens except those that enter the bloodstream directly.

18.

Which of the following terms describes foreign particles that enter a host and stimulate the bodys immune response?

A)

Macrophage

B)

Phagocyte

C)

Antibody

D)

Antigen

Ans:

D

Feedback:

Antigens are foreign particles, such as microbes, that enter a host.

19.

The process of phagocytosis involves

A)

Secretion of a nonspecific chemical inhibitor

B)

Depletion of serotonin in the brain cells

C)

Digestion of microbes by WBCs

D)

Breakdown of proteins into amino acids

Ans:

C

Feedback:

Many leukocytes function as phagocytes, digesting and destroying microbial invaders.

20.

What is the second line of defense in microbial invasion?

A)

Inflammation

B)

Infection

C)

Disease

D)

Disability

Ans:

A

Feedback:

The inflammatory response makes up the second line of defense to microbial invasion.